This commentary is by state Rep. David Yacovone, D-Morrisville, who is former commissioner of the Department of Aging and Disabilities, former commissioner of the Department for Children and Families, and past chair of the Public Oversight Commission.
The recent plans from the University of Vermont Medical Center regarding possible expansion of outpatient surgical care, the emergency department, psychiatric inpatient care and more raises many questions.
Understandably, the UVM Medical Center has a fiduciary obligation to protect the interests of the organization and to assure it is viable. But, who has the fiduciary interest and obligation to protect the rest of Vermont’s health care system? Who is charged with assuring Vermont’s health care system is viable so that all Vermonters have accessible, adequate and affordable health care?
Vermont has bestowed much of this obligation upon the Green Mountain Care Board. It is not an easy job. The dedicated people who work there are asked to do much. If the Green Mountain Care Board looks at proposals such as UVM’s, however well intended, in isolation from the system as a whole, how can it ensure the rest of Vermont’s health care system will be viable too?
If the proposal from UVM, albeit in its very early stages, is approved, will there be the financial wherewithal to meet the other health care needs facing Vermonters? Surely other Vermont hospitals face the same pressures as UVM. They too must keep their facilities current and updated if they want to attract staff. And, what of the non-hospital sector of the health care system?
If the bricks and sticks of health care are tended to, will it be at the expense of primary care, or long-term care?
Will the some 55,000 Vermonters with diabetes be better off with proposals like the one offered by UVM? The short answer is no.
Will obesity be combatted with more hospital construction projects? The short answer is no.
Will Vermont’s rate of fatalities due to overdoses, ranked the fastest-growing in the nation recently by the CDC, change with more beds and operating rooms? The short answer is no.
The Green Mountain Care Board must put a moratorium on health care spending proposals intended to rebuild the hospital infrastructure, not because they may not be needed, but because we need to be sure what we do approve is most important. A project-by-project approach will not serve us well.
Vermont is watching.
